Home > Cost-effectiveness analysis of a hypothetical vaccine for schistosomiasis in Madagascar and Burkina Faso

This peer-reviewed article, published in Vaccine, evaluates the potential cost-effectiveness of alternative strategies for introducing a hypothetical schistosomiasis vaccine in Madagascar and Burkina Faso. The study uses a Markov model to estimate health and economic outcomes under different vaccination strategies and hypothetical vaccine profiles, drawing on country-specific cost-of-illness and health-related quality-of-life data.

Key findings and insights

  • Vaccination strategies targeting only school-aged children were generally not cost-effective under base-case assumptions (75% efficacy, 5 years’ protection, 70% coverage, US$7 per fully immunized person) in either country.
  • Extending vaccination to adults substantially improved cost-effectiveness in both settings, reflecting higher age-specific schistosomiasis prevalence among adults than among school-aged children in the underlying data.
  • In Madagascar, the routine-plus-adult-catch-up strategy (RT3CU4–59) was associated with an incremental cost-effectiveness ratio (ICER) of US$278 per QALY gained.
  • In Burkina Faso, the same strategy was cost-saving (dominant) compared with no vaccination, generating additional QALYs while reducing overall costs.
  • Duration of vaccine protection had a greater influence on cost-effectiveness than vaccine efficacy, and the adult-inclusive strategy had the highest probability of being cost-effective in both countries.

How can the findings be used?

These findings can inform early-stage value assessments and target-population design for schistosomiasis vaccine candidates still under development. Since cost-effectiveness depended strongly on including adults rather than restricting vaccination to school-aged children, this may be a relevant consideration for future country-level policy discussions once a licensed vaccine becomes available.

Thumbnail image credit: GAVI

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